During Covid-19 Pandemic, Which Office Visits Does Your Child Need

With much of the nation practicing social distancing, many parents are wondering when and whether to bring their children to see the pediatrician for check ups, immunizations and sick visits.

The covid-19 pandemic is a complicated and scary time, and we are taking every precaution to keep you and your children safe.

Here’s some guidance on when to bring your child in for an appointment and when a telehealth visit would probably do the trick.

Well Visits

Health assessments, or well visits, are an opportunity for pediatricians to review your child’s health. We take height and weight measurements; discuss any concerns you may have; and track developmental milestones. Depending on the age of the child, we administer immunizations.

At Permanente Medicine, we are postponing health assessments for children older than 15 months of age. For children without significant medical issues, we are offering the 1-month appointment using telehealth – either over the phone or through video. The 9-month appointment is optional if the child is up-to-date with immunizations. If the child is, in fact, up to date, that appointment could be done virtually or be postponed.

Immunizations, however, are vitally important to children, protecting them – and our community – against diseases such as diphtheria, hepatitis A and B, measles, mumps, whooping cough, rubella, chicken pox and polio, among others. We urge parents to bring in their children for these important immunizations, which we administer at appointments when children are 2 months, 4 months, 6 months, 12 months and 15 months.

For children older than 15 months of age, it is safe to postpone any immunizations until the pandemic has resolved. Postponing the vaccines will not affect immunizations previously given. For example, if your child received two out of three doses of the HPV vaccine, we will not need to restart the series if the third dose is postponed.

When coming in for an appointment, only one parent should come with the child. Many doctors’ offices are confirming that parents don’t have any covid-19 symptoms – fever, cough, respiratory distress -- before letting the parent accompany the child.

Car seats, diaper bags, books, toys and strollers should be kept in the car and should not be brought into the exam room because they can carry viral particles. Many pediatric offices have removed toys and books from the waiting room.

Other recommendations:

Parents and children should wash hands before coming to the pediatrician’s office and should wash again when leaving.

Don’t touch your face, and remind children not to touch their faces.

Please don’t allow children to play with the computer keyboard in the exam room. While waiting for the doctor to come in, children often are tempted to play with the keyboard in the exam room. Tell children no because we are trying to prevent spreading germs.

Fortunately, pediatricians can help parents and children with a variety of medical concerns by conducting virtual visits, at least as a first step:

Rashes. If your child has a rash, take a picture and send it to the pediatrician.

Traumas and injuries. Pediatricians can assess injuries and traumas with video visits. If we think it’s needs a further look, we’ll talk about next steps.

Earaches. If an older child has an earache, we can offer medical advice over the phone and see if the pain subsides. Younger children may need to be seen in the office.

Stomach aches. If a parent can give a good description of the child’s stomach aches, pediatricians can usually offer sound medical advice via a virtual visit.

Sore throats. We’ll consider your child’s history of strep. Depending on the circumstances, a child may need to come in for a quick strep test.

Fever. Pediatricians don’t need to see every child with a fever. We can start with a virtual visit and see how the child responds to rest, fluids and fever-reducing medications.

Special Considerations

Children with chronic conditions, such as asthma, should continue taking their preventive medicines and using their inhalers regularly.

Parents of immunocompromised children should call the pediatrician if they see their children have any problems with their condition.

Parents of children who exhibit any of the following symptoms should call the doctor immediately:

Fast or shallow breathing

Seizures

Gasping for air

Confusion

Chest pain

Lethargy or difficulty waking the child

Finally, if your child has a fever, cough or fast breathing and you suspect your child has the novel coronavirus, call your pediatrician. Your pediatrician will counsel you on how to care for your child at home and when to go to the doctor’s office or emergency room.

In this difficult time, pediatricians want to be there for families and children, even if their chief complaint isn’t an emergency. Please reach out to your child’s pediatrician with any questions or concerns.

Mid-Atlantic Permanente Medical Group, P.C. (Permanente) is our network of over 1,500 physicians who practice in our medical centers located in Maryland, the District of Columbia, and Virginia.

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